Vitiligo is a skin disease that affects 1% of the population. Vitiliginous skin does not contain pigment-producing cells called melanocytes. This leaves the appearance of white patches on the skin, which can either be generalized or localized. It is important for dermatology nurses to understand the basic pathophysiology of vitiligo, the various treatment methods, how to protect vitiliginous skin, and the psychological impact of the disease.
Vitiligo is a depigmentation of the skin, which presents as localized or generalized white patches. Vitiligo affects 1% of the general population (Mason, 1997). Nurses can help patients with vitiligo by providing information about the disease, treatments (including cosmetic concealers), treatment side effects, support and informational systems, and methods on coping.
Vitiligo appears as a result of loss of melanin (skin pigment). Melanin is produced in cells called melanocytes. If melanocytes die or cannot form melanin, the skin becomes lighter or completely white. Documentation of the name "vitiligo" occurred in the first century A.D. when the Roman physician Celsus wrote De Medicina (Kovacs, 1998). Indian literature dating from 1500 to 1000 B.C. refers to the words kilas ("kil" means white, "as" means to cast or throw away) and palita ("pal" implies gray, old, and aged), referring to white patches on the skin (Kovacs, 1998). In the sacred book of Buddhism Vinay Pitak (624-544 B.C.), persons suffering from kilas were unable to be ordained. In the Indian scripture Manusmriti (200 B.C.), those members of society suffering from "svira" (spreading whiteness) were not respected (Kovacs, 1998).
Vitiligo affects one or two of every 100 people (American Academy of Dermatology [AAD], 2000). Vitiligo affects persons of all ethnic origins and both sexes. Vitiligo usually begins in childhood or young adulthood, and the disease is usually diagnosed before the age of 20 (Kovacs, 1998). The incidence decreases with increasing age. Patients often associate the onset of their disease with emotional or physical stress (Kovacs, 1998).
